After over two years of trying to conceive, Ms. Hanh and her husband visited the Center for Reproductive Assistance, Tam Anh General Hospital Ho Chi Minh City (IVF Tam Anh Ho Chi Minh City) for an examination. Dr. Nguyen Thi Thuy, a Master of Science, reported that Ms. Hanh's ovarian reserve was normal, both fallopian tubes were clear, and her husband's sperm showed no abnormalities.

However, for women over 40, egg quality declines, and the risk of chromosomal abnormalities in embryos increases. This reduces the chance of successful implantation and raises the risk of pregnancy loss or miscarriage. The doctor advised the couple to undergo in vitro fertilization (IVF) combined with preimplantation genetic testing to select healthy embryos, thereby increasing their chances of conception.

Dr. Nguyen Thi Thuy advises Ms. Hanh on an infertility treatment plan. Photo: IVF Tam Anh

Dr. Thuy stimulated Ms. Hanh's ovaries, retrieving 11 mature oocytes. These were then fertilized using intracytoplasmic sperm injection. The embryos were cultured in a Time-lapse system integrated with artificial intelligence (AI) for continuous monitoring, which helps assess implantation potential. The couple obtained 7 day-5 embryos, with 5 of them being of good quality.

Three embryos underwent preimplantation genetic testing for aneuploidy (PGT-A). Results showed two embryos had normal chromosome sets, while the remaining embryo was aneuploid and had to be discarded.

An embryologist performs preimplantation genetic testing to select the optimal embryo before transfer. Photo: IVF Tam Anh

Dr. Thuy prepared Ms. Hanh's uterine lining, ensuring adequate thickness and favorable morphology for embryo transfer. However, the transfer was unsuccessful. According to the doctor, the cause might have been related to uterine cavity abnormalities not detected through standard examination methods.

The doctor then performed a hysteroscopy, which revealed dual lesions: chronic endometritis and endometriosis. Endometriosis is a condition where endometrial tissue grows in other organs such as the uterine muscle, ovaries, fallopian tubes, or abdominal cavity, or even directly beneath the endometrial lining. When endometriosis coexists with chronic endometritis, it alters the endometrial environment, preventing embryo implantation.

The doctor treated Ms. Hanh for the dual condition over four weeks before proceeding with another embryo transfer. This time, Ms. Hanh successfully conceived and gave birth to her first daughter in the 38th week of pregnancy, weighing 2,8 kg.

According to Dr. Thuy, infertility in women over 40 often involves multiple factors. Age affects egg quality and the risk of chromosomal abnormalities in embryos, while uterine conditions can reduce the embryo's ability to implant. Patients require individualized assessment and treatment based on their age, ovarian reserve, and treatment history. The doctor combines clinical examination, ultrasound, hysteroscopy, and necessary tests to identify factors that may impact embryo implantation, developing a suitable protocol to help patients achieve pregnancy sooner.

Nguyet Nhi

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